恶性梗阻性黄疸的外科姑息治疗

不能切除肿瘤的恶性梗阻性黄疸的外科姑息治疗方法繁多，本文介绍自1989年以来，采取开腹经不同途径的带支撑导管胆肠内引流的方法治疗30例，减黄确切，尚对7例高位胆管癌在解除胆道梗阻的基础上行术后(192)Ir和(60)Co联合放疗，提高了病人生存质量及延长了生命。     

“凝血抑制物”影响骨折患者凝血功能的探讨——附12例骨折患者凝血试验结果分析

目的:对骨折患者凝血功能的改变进行探讨。方法:凝固法测凝血酶原时间(PT),活化的部分凝血活酶时间(APTT),凝血酶时间。结果:患病组的PT和APTT较正常对照组有显著延长,且不能被正常新鲜血浆纠正。结论:骨折患者凝血异常多因凝血抑制物增多所致。     

Acute vascular rejection is associated with up-regulation of vitronectin receptor (alphavbeta3), increased expression of tissue factor, and activation of the extracellular matrix metalloproteinase induction system.

BACKGROUND: A cascade of inflammatory reactions characterize acute vascular rejection after heart transplantation. This study was undertaken to test the hypothesis that acute vascular rejection is associated with up-regulation of vitronectin receptor (alphavbeta3), increased expression of tissue factor, and activation of the extracellular matrix metalloproteinase induction system. METHODS: Acute vascular rejection developed in 14 heart transplant recipients within 2 weeks of transplantation, confirmed by immunofluorescence (AVR group). We compared these patients with 10 transplant recipients who had no evidence of acute vascular rejection or peritransplant ischemic injury (control group). We evaluated endomyocardial biopsy specimens for alphavbeta3, tissue factor, and extracellular matrix metalloproteinase inducer (EMMPRIN). RESULTS: Compared with the control group, the AVR group demonstrated evidence of significantly increased expression of alphavbeta3 (1.9-fold, p < 0.001), tissue factor (1.8-fold, p < 0.001), and EMMPRIN (1.5-fold, p < 0.001). All patients in the AVR group received plasmapheresis; 11 of 14 patients had evidence of ischemic necrosis on biopsy specimens, and 3 of 14 patients experienced hemodynamic compromise and graft dysfunction and died within 3 weeks of transplant. Another patient died at 10 months after transplant. CONCLUSIONS: Acute vascular rejection is associated with up-regulation of alphavbeta3, tissue factor, and activation of the matrix metalloproteinase induction system, which may contribute to the lethal morbidity associated with this disease.     

Treatment of Motor Neuron Disease with Qi-invigorating Herbs—— A Report of 31 Cases

The motor neuron disease (MND) refers to a group of progressive diseases with unknown reasons, which attacks the cells of the anterior horn of the spinal cord, the motor nuclei of the brain stem cranial nerves and the pyramidal cells of the cerebral motor cortex. It is characterized in clinic by atrophy of the muscles, myasthenia and even death due to paralysis of the respiratory muscle. Currently, there is still no any effective cure for this illness. 50-70% of the victims will die in 3 to 5 years, and the survival time for those with brain stem injuries is no more than two years.1 Since 1996, the authors have treated 31 cases of motor neuron disease with large dosage of qi-invigorating drugs in accordance with Prof. Liu Mocai's experience, and obtained certain therapeutic effects. A report follows.     

原代培养神经细胞膜经N—甲基—D—D天冬氨酸和MK—801作用后原子力微镜观察

目的：对比观察正常培养皮层神经元在N－甲基－D－天冬氨酸（NMDA）及其受体拮抗剂－MK－801作用下膜表面三维构像形态的改变。方法：利用分辨率为0．1－0．01nm的原子力显微镜（AFM）对原代培养大鼠皮层神经细胞膜表面进行纳米尺度的扫描观测。结果：正常神经元膜表面光滑，起伏均匀，隆起的颗粒状蛋白密集，间隔规律。NMDA损伤后神经元破碎，崩解，膜失去连续性，NMDA＋MK－801作用下神经元膜皱折增加，边缘粗糙，起伏程度介于前两者之间，结论：（1）AFM具有分辨率高，制样简单特点，（2）AFM能细微地分辨损伤保护作用后引起的细胞膜表面三维形态改变。（3）NMDA作用后膜结构开始解体，膜蛋白颗粒聚集增大，脂质凹陷加深，间距增宽，表面粗糙度增加。     

高脂血症患者C—反应蛋白含量的变化及氟伐他汀对它的影响

OBJECTIVE: To observe the changes of C-reactive protein (CRP) level and its relationship with blood lipids, and the effects of fluvastatin on CRP and the lipids in patients with hyperlipidemia. METHODS: Serum levels of cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very-low-density lipoprotein cholesterol (VLDL-C) and lipoprotein(a)[Lp(a)] were measured by enzyme assay, and plasma CRP level by immunonephelometry before and after fluvastatin treatment (20 mg/d for 4 weeks) in patients with hyperlipidemia. RESULTS: CRP levels were above normal in 90.3% hyperlipidemia cases in spite of the various accompanying diseases. Fluvastatin treatment significantly reduced TC (-7.49%), TG (-14.32%), LDL (-13.88%), VLDL (-18.48%) and TC/HDL(-13.50%) levels (P<0.01), and also brought down Lp(a) concentration (-13.81%). CRP levels was very effectively reduced after the treatment (-15.92%, P<0.001). No association between basal CRP levels and basal lipids and Lp(a) concentrations was observed. Positive correlation of CRP, however, was observed after fluvastatin treatment with TC/HDL (r=0.62, P=0.041) and Lp(a) (r=0.320, P=0.011), while inverse relations were noted between CRP and HDL (r=-0.288, P=0.023). CONCLUSION: CRP levels increases markedly in patients with hyperlipidemia, a fact that is independent of the accompanying diseases. In addition to modulating blood lipid levels, fluvastatin also reduces CRP level, the latter possibly serving as an independent predictive factor for atherosclerotic cardiovascular diseases and also as an indicator for estimating the effectiveness of the treatment.     

免疫抑制剂在异体造血干细胞移植中的应用

异体造血干细胞移植的重要并发症是移植物抗宿主病(GVHD),免疫抑制剂是有效防治GVHD的一类药物.在异体造血干细胞移植后应用免疫抑制剂,使得GVHD发生率下降,严重程度减轻.本文对几类主要的免疫抑制剂的作用机理以及在异体造血干细胞移植中作为预防和治疗GVHD的应用作一综述.     

湿润烧伤膏治疗外伤性末节指(趾)骨外露体会

目的：探讨MEBO治疗骨外露的临床疗效。方法：对2005年10月至2006年2月处置外伤性指（趾）骨外露3例采用MEBO治疗。结果：3例创面全部愈合,时间均为3周。结论：MEBO治疗外伤性末节指（趾）骨外露简便,实用,疗效可靠,不影响美观。     

武警部队医学生心理健康状况调查

目的　了解武警部队医学生心理健康状况 ,探讨增进武警部队学员心理健康的对策。方法　采用症状自评量表 (SCL - 90 )为工具 ,对随机抽取的 312名武警医学生进行心理健康状况测试。结果　武警医学生SCL - 90各项因子分普遍低于武警军人组和国内常模青年组 (P<0 .0 5 ) ;总均分 1.39± 0 .34,低于武警军人组 (1.4 7± 0 .4 2 ,P <0 .0 1)。结论　武警医学生心理健康状况优于武警军人和国内常模青年组。但仍存在问题 ,部队教育工作者应根据武警院校学员特点 ,积极开展心理卫生教育 ,以提高军校学员整体心理素质     

常见阴离子对血清氯离子选择性电极法测定的影响

目的:研究离子选择性电极在测定血清氯时的影响因素。方法:用E-555电解质分析仪测定氟化钠、溴化钠、碳酸氢钠、硫氰化钾、碘化钾、铁氰化钾、硫化钠以及叠氮钠溶液,并将溴化钠、硫氰化钾、碘化钾、铁氰化钾、硫化钠、叠氮钠分别加入Cl~-均值为100mmol/L的混合血清中观察其具体的干扰情况。结果:所测8种物质中氟化钠、碳酸氢钠的影响较小,而溴化钠、铁氰化钾、碘化钾、铁氰化钾、硫化钠、叠氮钠的影响较大。结论:溴离子、碘离子、硫离子、氢氰根离子、叠氮钠对离子选择性电极法影响性较大,我们在工作中应加以重视。